Passengers have begun to disembark the cruise ship at the centre of the hantavirus outbreak, Spain’s ministry of health said, in a carefully managed repatriation operation involving multiple nations.

The vessel, MV Hondius, had earlier Sunday morning docked at the Spanish Island of Tenerife carrying 147 people. Passengers were seen being ferried in small boats from the cruise ship anchored at the Port of Granadilla to the island.

After reaching the island, disembarked passengers filed onto waiting buses, to be taken to the airport. From there, they will be evacuated to their home countries.

Prior to disembarking, medical teams boarded the ship to run tests on passengers and crew, Spain’s health minister Monica Garcia said shortly before 8am local time (4pm AEST).

Since the vessel departed Argentina last month, the deaths of three people have been linked to hantavirus — a rare disease typically caused by exposure to infected rodents’ urine or faeces — while others have been evacuated from the ship for medical treatment.

Local officials earlier said the ship will anchor at “the safest” distance from the dock, local officials said, and passengers will be brought ashore by nationality in small boats with a maximum capacity of 10 people, according to the tour operator Oceanwide Expeditions.

Several nations — including the US, Germany, France, Belgium, Ireland and the Netherlands — are sending aircraft to evacuate their nationals who were on the ship.

Four Australians will also be evacuated from the ship.

“The sequence of disembarkation will be coordinated with arriving repatriation flights,” Oceanwide said, adding that passengers’ luggage would remain on the ship and be returned to them later.

A US Centers for Disease Control and Prevention official said that the 17 American passengers —none of whom have symptoms — will be transported to the University of Nebraska Medical Center, which is home to the National Quarantine Unit, a federally funded facility.

After briefly being assessed at the unit, the passengers will then be able to undergo home-based monitoring over the next 42 days, the official said, with monitoring expected to be at least daily.

Fourteen Spanish passengers are expected to disembark the vessel first and will wear FFP2 masks – along with those involved in bus transfers and logistics, Garcia said.

They will be taken to a military hospital, where they will stay in individual rooms with no visitors allowed, and will receive a PCR test upon arrival and another seven days later, Spain’s health ministry said.

The two Dutch passengers on board will be the second group to leave the vessel, Garcia said.

The boat’s arrival has caused tensions in the Canary Islands, an autonomous community of Spain, with the territory’s leader Fernando Clavijo saying earlier in the week that he was opposed to the ship docking there.

Port workers in Tenerife have also held protests, voicing their concerns about a lack of communication about the potential risks.

The ship and its crew are scheduled to continue to Rotterdam in the Netherlands, where the crew will disembark and the ship will be disinfected.

The hantavirus outbreak was first reported to the World Health Organization on May 2 and remains a low risk to the general public, the WHO said.